In September 2016, Queen's University launched the first, fully online, 4-year Bachelor of Health Science degree program in Canada. This paper reports on the developmental structure, implementation philosophy, and challenges in the development of this competency-based program. All stakeholders directly involved in program development were invited to participate in this qualitative case study. Thirty-five interviews and three focus groups (n=14) were conducted. Interviews and focus groups were transcribed verbatim and data were analyzed using thematic design. Themes included: program vision; desired program outcomes; administrative processes for funding and recruitment; uniqueness of the program; local, regional and international impact of the program; communication and collaborations for program development; and uncertainty in long term outcomes. Findings suggest that during program development, an explicit vision of program goals encouraged buy-in at most levels of the university. There was consensus that the overarching outcome should be to provide a rigorous, high quality program with pathways to professional, basic science, global health and advocacy-based health professions. The online modality was expected to improve accessibility to degree programs, as well as address diverse student learning needs. Innovation played a vital role in the program's development and was founded in educational theory and curriculum development practices.